A CASE OF IDIOPATHIC SEGMENTAL DILATATION OF THE SMALL BOWEL WITH ASCITES CHYLOSA

Abstract

Idiopathic segmental dilatation of the small bowel occurs so rarely that only 43 cases have been reported, which is decreased to 5 if limited to adult cases. We encountered a case of the disease presenting with acute abdomen, which resulted in ascites chylosa. The case was a 18-year-old man complaining of right lower abdominal pain. He underwent laparotomy with a suspicion of acute appendicitis, and a slight degree of inflammation in the appendix, ascites chylosa and dilatated small bowel were found. The ileum was twisted at the dilated site, and a retention and transudation of lymph fluid were seen through the enteric wall at the site and mesentric lymph vessels, which might cause ascites chylosa. Surgical treatments included appendecyomy and torsion. Postoperative fluoroscopy of the intestine revealed a segmental dilatation of the small bowel, however, the patient has good health without particular symptom.